Provider Demographics
NPI:1922103993
Name:TSAMBIS, ELIAS (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:
Last Name:TSAMBIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31673 CRYSTAL SANDS DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2709
Mailing Address - Country:US
Mailing Address - Phone:845-358-6530
Mailing Address - Fax:
Practice Address - Street 1:31673 CRYSTAL SANDS DR
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677
Practice Address - Country:US
Practice Address - Phone:845-358-6530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1489332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A64357Medicare UPIN
NY80D932Medicare ID - Type Unspecified